BSN 366 MODULE 4 HESI EXAM | QUESTIONS WITH
CORRECT ANSWERS AND DETAILED RATIONALES | 2026/27
UPDATED | 100% CORRECT - NIGHTINGALE COLLEGE.
80 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN 366 MODULE 4 HESI EXAM | QUESTIONS WITH CORRECT ANSWERS AND DETAILED RATIONALES |
2026/27 UPDATED | 100% CORRECT - NIGHTINGALE COLLEGE.. It contains 80 carefully selected questions
that reflect the most current exam content and testing strategies. Each question is accompanied by a correct
answer and a detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 80 Questions
Foundations - Application - BSN 366 Module 4 HESI WITH Correct AND Detailed Rationales 2026/27
Updated 100 Correct - Nightingale College Maternal-newborn Nursing AND Women S Health Undergraduate
YEAR 3 BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-14 Weeks Gestation, Finding, Likely, Postpartum, Indicates
Safety AND Infection Control 15-28 Prescribed, Likely, Medication, Receiving, Cause
Health Promotion AND 29-42 Finding, Intervention, Therapy, Serum, Presents
Maintenance
Psychosocial Integrity 43-56 Potassium, Mechanism, Chronic, Finding, Level
Basic CARE AND Comfort 57-70 Prescribed, Finding, Therapy, Appropriate, Units
Pharmacological Therapies 71-80 Chronic, Kidney, Disease, Anemia, Serum
TOTAL 80 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
A client at 34 weeks gestation presents with persistent hypertension and new-onset
proteinuria. Which finding would most likely prompt the healthcare provider to diagnose
severe preeclampsia rather than gestational hypertension?
A. Blood pressure of 150/95 mmHg on two B. Urine protein-to-creatinine ratio of 0.2
occasions 6 hours apart
C. Platelet count of 90,000/mm³ D. Elevated liver enzymes with epigastric
pain
Correct: C - Platelet count of 90,000/mm³
Rationale:Severe preeclampsia is diagnosed when blood pressure is "e160/110 mmHg or
when there is evidence of end-organ damage, including thrombocytopenia (platelets
<100,000/mm³), impaired liver function, renal insufficiency, pulmonary edema, or
cerebral/visual symptoms. A platelet count of 90,000/mm³ is a severe feature. The other
options do not meet the criteria for severe disease.
Why the other answers are wrong:
A. Blood pressure of 150/95 mmHg is not severe (160/110) and could be nonsevere
preeclampsia or gestational hypertension.
B. A protein-to-creatinine ratio of 0.2 is below the diagnostic threshold for significant proteinuria
(0.3).
D. Elevated liver enzymes with epigastric pain may indicate HELLP syndrome, but the question
asks for a finding that would diagnose severe preeclampsia as opposed to gestational
hypertension; this is a severe feature, but thrombocytopenia is a more definitive criterion.
Reference: Cunningham, F.G., et al. (2026). Williams Obstetrics, 26th Ed., Ch. 40
Q2.
A postpartum client who delivered 12 hours ago has a fundus that is boggy and displaced
to the right of the umbilicus. Which intervention should the nurse perform first?
A. Massage the fundus in a circular motion B. Administer oxytocin as prescribed
C. Assist the client to empty her bladder D. Measure the client's blood pressure and
pulse
Correct: C - Assist the client to empty her bladder
Rationale:A boggy and displaced fundus strongly indicates bladder distention, which elevates
the uterus and prevents effective contraction. The nurse should first assist the client to void,
as an empty bladder allows the uterus to contract and reduces the risk of hemorrhage.
Massage and oxytocin are appropriate only after the bladder is emptied.
Page 3
, Section A - Management OF CARE
Why the other answers are wrong:
A. Massage is appropriate for a boggy fundus that is NOT displaced, but displacement suggests bladder distention, which must be corrected
first.
B. Oxytocin may be needed later, but the immediate priority is relieving bladder distention to allow uterine contraction.
D. Vital signs are important but do not address the cause of uterine atony; the first action should be to correct the bladder distention.
Reference: Perry, S.E., et al. (2026). Maternal Child Nursing Care, 7th Ed., Ch. 33
Q3.
A primigravid client in active labor has an epidural placed. Which assessment finding
indicates the need for immediate anesthesiology notification?
A. Blood pressure decrease from 120/80 to B. Pruritus over the abdomen and chest
100/60 mmHg
C. Numbness and tingling in the lower D. Difficulty breathing and complaints of
extremities chest tightness
Correct: D - Difficulty breathing and complaints of chest tightness
Rationale:Difficulty breathing and chest tightness after epidural placement suggest a high
spinal block or local anesthetic systemic toxicity, which requires immediate anesthesiology
intervention. Hypotension is common and managed with fluids and positioning. Pruritus is a
side effect of opioids. Numbness in the lower extremities is expected.
Why the other answers are wrong:
A. Hypotension is an expected side effect of epidural anesthesia and is managed
conservatively before notifying anesthesia.
B. Pruritus is a common side effect of intrathecal opioids and is not an emergency.
C. Lower extremity numbness is an expected effect of the epidural block.
Reference: Gaiser, R. (2026). Chestnut's Obstetric Anesthesia, 7th Ed., Ch. 12
Q4.
A neonate born at 38 weeks gestation has respiratory distress. An arterial blood gas
shows pH 7.20, PaCO2 60 mmHg, PaO2 50 mmHg, and bicarbonate 24 mEq/L. Which
condition is most consistent with these findings?
A. Metabolic acidosis with partial B. Acute respiratory acidosis
compensation
C. Chronic respiratory acidosis with renal D. Mixed respiratory and metabolic acidosis
compensation
Correct: B - Acute respiratory acidosis
Page 4
CORRECT ANSWERS AND DETAILED RATIONALES | 2026/27
UPDATED | 100% CORRECT - NIGHTINGALE COLLEGE.
80 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN 366 MODULE 4 HESI EXAM | QUESTIONS WITH CORRECT ANSWERS AND DETAILED RATIONALES |
2026/27 UPDATED | 100% CORRECT - NIGHTINGALE COLLEGE.. It contains 80 carefully selected questions
that reflect the most current exam content and testing strategies. Each question is accompanied by a correct
answer and a detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 80 Questions
Foundations - Application - BSN 366 Module 4 HESI WITH Correct AND Detailed Rationales 2026/27
Updated 100 Correct - Nightingale College Maternal-newborn Nursing AND Women S Health Undergraduate
YEAR 3 BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-14 Weeks Gestation, Finding, Likely, Postpartum, Indicates
Safety AND Infection Control 15-28 Prescribed, Likely, Medication, Receiving, Cause
Health Promotion AND 29-42 Finding, Intervention, Therapy, Serum, Presents
Maintenance
Psychosocial Integrity 43-56 Potassium, Mechanism, Chronic, Finding, Level
Basic CARE AND Comfort 57-70 Prescribed, Finding, Therapy, Appropriate, Units
Pharmacological Therapies 71-80 Chronic, Kidney, Disease, Anemia, Serum
TOTAL 80 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
A client at 34 weeks gestation presents with persistent hypertension and new-onset
proteinuria. Which finding would most likely prompt the healthcare provider to diagnose
severe preeclampsia rather than gestational hypertension?
A. Blood pressure of 150/95 mmHg on two B. Urine protein-to-creatinine ratio of 0.2
occasions 6 hours apart
C. Platelet count of 90,000/mm³ D. Elevated liver enzymes with epigastric
pain
Correct: C - Platelet count of 90,000/mm³
Rationale:Severe preeclampsia is diagnosed when blood pressure is "e160/110 mmHg or
when there is evidence of end-organ damage, including thrombocytopenia (platelets
<100,000/mm³), impaired liver function, renal insufficiency, pulmonary edema, or
cerebral/visual symptoms. A platelet count of 90,000/mm³ is a severe feature. The other
options do not meet the criteria for severe disease.
Why the other answers are wrong:
A. Blood pressure of 150/95 mmHg is not severe (160/110) and could be nonsevere
preeclampsia or gestational hypertension.
B. A protein-to-creatinine ratio of 0.2 is below the diagnostic threshold for significant proteinuria
(0.3).
D. Elevated liver enzymes with epigastric pain may indicate HELLP syndrome, but the question
asks for a finding that would diagnose severe preeclampsia as opposed to gestational
hypertension; this is a severe feature, but thrombocytopenia is a more definitive criterion.
Reference: Cunningham, F.G., et al. (2026). Williams Obstetrics, 26th Ed., Ch. 40
Q2.
A postpartum client who delivered 12 hours ago has a fundus that is boggy and displaced
to the right of the umbilicus. Which intervention should the nurse perform first?
A. Massage the fundus in a circular motion B. Administer oxytocin as prescribed
C. Assist the client to empty her bladder D. Measure the client's blood pressure and
pulse
Correct: C - Assist the client to empty her bladder
Rationale:A boggy and displaced fundus strongly indicates bladder distention, which elevates
the uterus and prevents effective contraction. The nurse should first assist the client to void,
as an empty bladder allows the uterus to contract and reduces the risk of hemorrhage.
Massage and oxytocin are appropriate only after the bladder is emptied.
Page 3
, Section A - Management OF CARE
Why the other answers are wrong:
A. Massage is appropriate for a boggy fundus that is NOT displaced, but displacement suggests bladder distention, which must be corrected
first.
B. Oxytocin may be needed later, but the immediate priority is relieving bladder distention to allow uterine contraction.
D. Vital signs are important but do not address the cause of uterine atony; the first action should be to correct the bladder distention.
Reference: Perry, S.E., et al. (2026). Maternal Child Nursing Care, 7th Ed., Ch. 33
Q3.
A primigravid client in active labor has an epidural placed. Which assessment finding
indicates the need for immediate anesthesiology notification?
A. Blood pressure decrease from 120/80 to B. Pruritus over the abdomen and chest
100/60 mmHg
C. Numbness and tingling in the lower D. Difficulty breathing and complaints of
extremities chest tightness
Correct: D - Difficulty breathing and complaints of chest tightness
Rationale:Difficulty breathing and chest tightness after epidural placement suggest a high
spinal block or local anesthetic systemic toxicity, which requires immediate anesthesiology
intervention. Hypotension is common and managed with fluids and positioning. Pruritus is a
side effect of opioids. Numbness in the lower extremities is expected.
Why the other answers are wrong:
A. Hypotension is an expected side effect of epidural anesthesia and is managed
conservatively before notifying anesthesia.
B. Pruritus is a common side effect of intrathecal opioids and is not an emergency.
C. Lower extremity numbness is an expected effect of the epidural block.
Reference: Gaiser, R. (2026). Chestnut's Obstetric Anesthesia, 7th Ed., Ch. 12
Q4.
A neonate born at 38 weeks gestation has respiratory distress. An arterial blood gas
shows pH 7.20, PaCO2 60 mmHg, PaO2 50 mmHg, and bicarbonate 24 mEq/L. Which
condition is most consistent with these findings?
A. Metabolic acidosis with partial B. Acute respiratory acidosis
compensation
C. Chronic respiratory acidosis with renal D. Mixed respiratory and metabolic acidosis
compensation
Correct: B - Acute respiratory acidosis
Page 4
